Letter from the Parliamentary Clerk, Department
of Health, to the Clerk of the Committee
PUBLIC EXPENDITURE INQUIRY (PEI) 2000: FOLLOW
UP INFORMATION
This letter sets out the Department's response
about the additional information we agreed to provide at the hearings
for this year's PEI.
1. Nursing care—patients' right of appeal
against assessment of eligibility
We envisage that patients will have the right
to appeal against an assessment under arrangements similar to
those set out in the guidance Discharge from NHS Inpatient
Care of People with Continuing Health or Social Care Needs: Arrangements
for Reviewing Decisions on Eligibility for NHS Continuing Inpatient
Care. (HSG (95) 39/LAC (95) 17). The arrangements will be
set out next year in guidance to the NHS and local authorities
on free nursing care.
The review procedure will be an additional safeguard
for patients who believe they require registered nursing care
in a nursing home and who consider that the assessment and/or
application of eligibility criteria have not been correctly carried
out in their case. It will apply to all patients who have been
receiving NHS inpatient care, whether in a hospital, or arranged
and funded by the NHS in a hospice, nursing home, or elsewhere,
and to all client groups covered in local eligibility criteria.
The procedure will affect patients' rights under
existing NHS and local authority complaints procedures. NHS Complaints
Procedure encourages local resolution whenever possible, if necessary
by referral to a local "convenor".
2. Data on GP waiting times
Table 1, attached at Annex A, shows results
from the National Survey of NHS Patients, which was published
in October 1999. The survey only gives information on waiting
times to see a GP—there is no information held centrally
on the waiting times to see a nurse.
Care, however, should be taken when using the
data contained in table 1, as it could be an overestimate of waiting
time to see a GP because it relates specifically to the GP of
choice rather than another available GP within the practice. Full
results (At HA level) from this survey are available on the internet
at www.doh.gov.uk/public/nhssurvey.htm.
3. Data on the numbers of new intermediate
care beds, broken down into NHS provided and independent sector
provided beds
This information is not currently available.
4. Clarification on the reduction in geriatric
bed numbers (as shown in Bed Availability and Occupancy 2000—Table
4.13.1 of the Report)
The NHS Plan highlights the Government's wish
to build a bridge between hospital and home by developing a wide
range of intermediate care services to prevent avoidable admissions,
provide rehabilitation and enable as many people as possible to
maintain or regain independence in their own homes. This will
be done partly by investing more in NHS services, including giving
new life to community hospitals, and partly also by entering into
new partnerships with the independent sector.
In the Plan, it was stated that there will be:
— 7,000 extra NHS beds by 2004;
— of these around 2,100 extra beds
will be in general and acute wards—the first increase of
its kind in 30 years;
— 5,000 extra NHS funded intermediate
care beds, some in community or cottage hospitals, others in specially
designated wards in acute hospitals. Some will be in purpose built
new facilities or in redesigned private nursing homes;
— 1,700 extra non-residential intermediate
care places;
— a 30 per cent increase in adult critical
care beds over the next three years as a result of resources allocated
this year and to follow over the next three years.
These increases in beds and places, especially
for older people, should help improve bed availability in hospitals.
5. Information on the percentage of people
in residential nursing homes who (i) have all or most of their
nursing and personal care costs paid for; and (ii) of these the
proportion of patients who have sold their homes since being in
care
The Department does not hold information on
the number of people whose fees are paid for by the state but
have exhausted their funds through selling their home since being
in care.
However, the 1996 PSS Research Unit survey of
residential care provides some relevant information. The information
relates to permanent publicly funded residents aged 65 and over
in independent sector homes. Eleven per cent of the stock of elderly
permanent local authority supported residents had been self-funding
on admission. The equivalent figure for DSS funded preserved rights
residents was 23 per cent. These figures need to be treated with
caution as information on source of finance at admission was missing
for around 25 per cent of publicly funded elderly residents.
6. Supplementary questions on inflation
Responses to these two additional questions
are attached at Annex B.
I will be writing to you separately on the questions
relating to PFI and EU healthcare spend.
Finally, I would like to apologise for the time
it has taken for the Department to respond to the points raised
by the Committee members.
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